Registry-based Cross-sectional Study Research Articles

Epidemiology of traumatic spinal cord injury in Norway in 2012-2016: a registry-based cross-sectional study.

A registry-based cross-sectional study. To analyse the epidemiological and demographic characteristics of persons with traumatic spinal cord injury (TSCI) in Norway. TSCI patients admitted for primary rehabilitation to one of the three specialised spinal cord injury (SCI) departments (located in Bergen, Trondheim, and Oslo) and consented to the Norwegian Spinal Cord Injury Registry (NorSCIR). Analysis of data from NorSCIR during a 5-year period (2012-2016) was performed. Data were collected by using the International SCI Core Data Set as recommended by the International Spinal Cord Society (ISCoS). The lowest incidence of TSCI was 11.4/million (2012), and the highest incidence was 15.9/million (2014). In the study period, 349 individuals were registered with TSCI. In total, 76% were male, and the mean age was 47 (SD ± 19) years. We observed dominance in the 60-74 years age group. The distribution between tetraplegia and paraplegia was 48%/42%. For those initially classified as American Spinal Cord Injury Association Impairment Scale (AIS) grade A (complete injury), 77% remained grade A at discharge. Considerable changes during primary rehabilitation after incomplete lesions were observed. Most patients (68%) were discharged home after primary rehabilitation. Falls were the main cause of TSCI (47%) and occurred more often during the weekend. Through a National Medical Quality Registry based on internationally provided data sets, we are able to present systematic and updated data from Norway.

Non-traumatic spinal cord injury in Norway 2012-2016: analysis from a national registry and comparison with traumatic spinal cord injury.

Registry-based cross-sectional study. To describe and analyze epidemiological and demographic characteristics of non-traumatic spinal cord injury (NTSCI) and to compare persons with NTSCI and traumatic spinal cord injury (TSCI). A total of 225 non-traumatic and 349 traumatic SCI patients were admitted for primary rehabilitation at one of the three specialized SCI departments in Norway (located in Bergen, Trondheim, and Oslo) from 2012 to 2016. Patients who consented to registration in the Norwegian Spinal Cord Injury Registry (NorSCIR) were included. Data were collected using the International SCI Core Data Set, as recommended by the International Spinal Cord Society (ISCoS). Demographics and injury characteristics were analyzed descriptively. The NTSCI and TSCI groups were compared using a Mann-Whitney U test and chi-square test. The mean age of the NTSCI patients was 55 years, and 59% were male. The incidence of NTSCI was 7.7-10.4 per million person-years, which is lower than the incidence of TSCI. NTSCI individuals were older, less severely injured, and their length of stay at the hospital was shorter than the TSCI individuals. The results may be influenced by the inclusion criterion in the registry. This makes the analyzed sample for NTSCI less complete. However, the majority of patients with nonprogressive NTSCI are included in the NorSCIR. For the first time, we are able to provide the national epidemiological status on NTSCI based on available data from the national registry. Further studies are required to improve the capture of NTSCI for future incidence studies.

Prevalence of Parasomnias in Patients With Obstructive Sleep Apnea. A Registry-Based Cross-Sectional Study.

Objective: To assess the prevalence of parasomnias in relation to presence and severity of obstructive sleep apnea (OSA). We hypothesized higher parasomnia prevalence with higher OSA severity.Methods: The sample comprised 4,372 patients referred to a Norwegian university hospital with suspicion of OSA (mean age 49.1 years, 69.8% males). OSA was diagnosed and categorized by standard respiratory polygraphy (type 3 portable monitor). The patients completed a comprehensive questionnaire prior to the sleep study, including questions about different parasomnias during the last 3 months. Pearson chi-square tests explored differences according to the presence and severity of OSA. Furthermore, logistic regression analyses with the parasomnias as dependent variables and OSA severity as predictor were conducted (adjusted for sex, age, marital status, smoking, and alcohol consumption).Results: In all, 34.7% had apnea-hypopnea index (AHI) <5 (no OSA), 32.5% had AHI 5-14.9 (mild OSA), 17.4% had AHI 15-29.9 (moderate OSA), and 15.3% had AHI ≥30 (severe OSA). The overall prevalence of parasomnias was 3.3% (sleepwalking), 2.5% (sleep-related violence), 3.1% (sexual acts during sleep), 1.7% (sleep-related eating), and 43.8% (nightmares). The overall parasomnia prevalence was highest in the no OSA group. In the chi-square analyses, including all OSA groups, the prevalence of sleep-related violence and nightmares were inversely associated with OSA severity, whereas none of the other parasomnias were significantly associated with OSA severity. In adjusted logistic regression analyses the odds of sleepwalking was significantly higher in severe compared to mild OSA (OR = 2.0, 95% CI = 1.12–3.55). The other parasomnias, including sleep-related violence and nightmares, were not associated with OSA presence or severity when adjusting for sex and age.Conclusions: We found no increase in parasomnias in patients with OSA compared to those not having OSA. With the exception of sleepwalking, the parasomnias were not associated with OSA severity.

Delay in Diagnosis of Hemoglobulinopathies (Thalassemia, Sickle Cell Anemia): A Need for Management of Thalassemia Programs

Background: Hemoglobulinopathies (Thalassemia, Sickle cell anemia) are an important public health challenge worldwide with an estimated number of 330,000 affected newborns annually. Delay in diagnosis not only increases the morbidity and mortality rates, but also can lead to uncertainties about success of thalassemia prevention program (TPP). This study is the first to determine the delay in thalassemia diagnosis in Iranian population. Methods: This registry-based cross-sectional study was conducted on 1003 enrolled thalassemic patients in 2015 in Shiraz, Iran. Univariate and multivariate ordinal logistic regression models were used to assess the factors associated with delay in diagnosis. Results: Of 981 patients, 48.5% were female, 71.2% were thalassemia major, and 23.8% were death cases. The delay in diagnosis was observed among 64.9% of the patients with a mean of 13.4 months (95% CI: 10.9, 15.9). Multivariate ordinal logistic regression showed that girls (adjusted OR = 1.32), and dead patients (adjusted OR = 1.95) were more likely to have delayed diagnosis. There was an increasing trend of risk in delayed diagnosis associated with one-year per birth cohort. The ORs were 1.0, 1.52, 1.55, and 2.22, for birth cohort 1980 and earlier, 1981 - 1990, 1991 - 2000, and 2001 to the present, respectively (P for trend = 0.014). In addition, the odds of delayed diagnosis in thalassemia major patients were significantly 0.58 times lower than those with thalassemia intermedia. Conclusions: A high proportion of delayed diagnosis was found. These results could explain the poor outcomes for thalassemia patients. Educational programs for community and revising the TPP are required for early detection of the disease.

Geographical Variation in Antipsychotic Drug Use in Elderly Patients with Dementia: A Nationwide Study.

Use of antipsychotics in elderly patients with dementia has decreased in the past decade due to safety regulations; however use is still high. Geographical variation may indicate discrepancies in clinical practice and lack of adherence to evidence-based guidelines for the management of behavioral symptoms. To investigate potential geographical variances in use of antipsychotic drugs in dementia care. A registry-based cross-sectional study in the entire elderly population of Denmark (≥65 years) conducted in 2012. Data included place of residence, prescriptions filled, and hospital discharge diagnoses. Antipsychotic drug use among elderly with (n = 34,536) and without (n = 931,203) a dementia diagnosis was compared across the five regions and 98 municipalities in Denmark, adjusted for age and sex. In 2012, the national prevalence of antipsychotic drug use was 20.7% for elderly patients with dementia, with a national incidence of 3.9%. The prevalence ranged from 17.0% to 23.3% in the five regions and from 7.5% to 33.1% in the 98 municipalities, demonstrating an over four-fold difference. The observed geographical variation was more pronounced at municipal level as compared to regional level, suggesting that the variation may be related to variances in clinical practice in primary care. This study highlights an urgent need for further educating professional carers and physicians to guide non-pharmacological as well as pharmacological management of neuropsychiatric symptoms in elderly patients with dementia.

Treatment outcome of new smear positive pulmonary tuberculosis patients in Hamadan, Iran: A registry-based cross-sectional study

ObjectivesTreatment outcome of Tuberculosis (TB), as a key determinant to evaluate the effectiveness of TB control program, remains a public health challenge in many developed and developing countries. This study aimed to assess treatment outcomes of new smear-positive pulmonary tuberculosis (PTB). MethodsThis retrospective cross-sectional study was conducted on 510 registered new PTB patients in Hamadan province, Iran during 2005–13. The data were extracted from the National TB Program (NTP). The main outcome was treatment success. The results of evaluation of the associated factors with successful treatment were presented as Odds Ratios (OR), and bootstrap method was used to obtain 95% Confidence Interval (95% CI). All statistical analysis was performed at 0.05 significant levels using the Stata 12 (Stata Corp, College Station, TX, USA). ResultsOverall, successful treatment outcome was 83.1%, and 9.4% of the patients died during the study period. In univariate logistic regression, only hospitalization history was associated with successful treatment (OR=2.02, 95% CI: 1.25, 3.24). After adjustment for age, weight, and delayed diagnosis, the factors associated with successful treatment were gender and having HIV risk factors and hospitalization history. ConclusionTreatment success rate in our study was 83.1%, which is slightly lower than the success target set by World Health Organization (WHO). Key determinants of poor treatment success rate, such as male gender, and not having hospitalization history during the treatment period, should be considered in efforts aimed to improve the treatment outcome in the management of TB.

Prevalence of parasitic infections and associations with pregnancy complications and outcomes in northern Tanzania: a registry-based cross-sectional study.

BackgroundParasitic infection(s) during pregnancy have been associated with increased risk of pregnancy complications and adverse outcomes in low resource settings. However, little is known about their influence on pregnancy outcomes. This study aimed to determine the prevalence of parasitic infections and their association with pregnancy complications and adverse outcomes.MethodsA retrospective cross-sectional study was conducted using maternally-linked data from Kilimanjaro Christian Medical Center (KCMC) medical birth registry. Birth records from all women who delivered singleton infants from 2000–2011 were utilized. We excluded multiple gestations and rural medical referral for various medical complications. A total of 30,797 births were evaluated. Data analysis was performed using SPSS version 18.0. Odds ratio (ORs) with 95 % confidence intervals (CIs) for adverse pregnancy outcomes and complications associated with parasitic infections were estimated using multiple logistic regression models. A p-value of less than 5 % was considered statistically significant.ResultsThe most prevalent parasitic infection recorded was malaria (17.0 %), while helminths and amebiasis were infrequently recorded (0.6 % vs. 0.7 %, respectively). Women who had malaria during pregnancy had 13 % increased odds of having a preterm delivery (OR = 1.13; 95 % CI: 1.01–1. 26) as compared to those who were not infected. They also had 33 % increased odds of getting maternal anemia (OR = 1.33; 95 % CI: 1.11–1.72). Likewise, pregnant women who were recorded with helminths infections had 29 % increased odds of having maternal anemia as compared to those who had no helminths infection (OR = 1.29; 95 % CI:0.48–3.53). Moreover, pregnant women who were recorded to have amebiasis had 79 % increased odds of having a preterm delivery as compared to those who had no ameba infection (OR = 1.79; 95 % CI: 1.12–2.91).ConclusionsMalaria was the prevalent parasitic infection in the studied population while helminth and ameba infections were infrequently reported. These parasitic infections were also associated with increased risk of anemia and delivery of a preterm infant. These were the only three infections/infestations which were evaluated. Our analysis revealed that malaria, helminth and ameba infections during pregnancy is dangerous and has life threatening consequences. This highlight the need to provide early diagnosis and treatment for infected women to prevent pregnancy complications and associated adverse pregnancy outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1413-6) contains supplementary material, which is available to authorized users.

Gender Differences in the Age-Stratified Prevalence of Risk Factors in Korean Ischemic Stroke Patients: A Nationwide Stroke Registry-Based Cross-Sectional Study

Although ethnic or cultural differences affect prevalence of cardiovascular risk factors, limited information is available about the age- and gender-stratified prevalence of the risk factors in Asian stroke population. We assessed gender- and age-stratified prevalences of major risk factors in Korean stroke patients, and assumed that the gender differences are attenuated by adjustment with lifestyle factors. Using the nationwide hospital-based stroke registry, we identified 9417 ischemic stroke patients admitted between April 2008 and January 2011. Prevalence of hypertension, diabetes, hyperlipidemia, atrial fibrillation, prior stroke, and coronary heart disease was assessed in both genders by age groups. We analyzed gender differences of the prevalence among the age groups by calculating prevalence ratio, and further explored the influence of lifestyle factors on the gender difference in multivariable analyses. Hypertension and hyperlipidemia were more common in men until middle age, but after that more common in women, whereas diabetes was more common in women after 65 years of age. Atrial fibrillation increased steadily with age in both genders but was more common in women through all age groups. Prior stroke and coronary heart disease showed inconsistent gender differences. Gender differences in hypertension and diabetes among the age groups were attenuated by adjustment with accompanying risk factors including lifestyle factors. Korean women with stroke had more hypertension and hyperlipidemia after middle age, more diabetes after 65 years, and more atrial fibrillation throughout all ages. Strategies to control risk factors in women at risk for stroke are eagerly needed.

FRI0393 Long-term trends in clinical characteristics of paget’s disease of bone

BackgroundStudies conducted in different areas have shown a decrease in both the prevalence and severity of Paget’s disease of bone (PDB) in the last few years [1]. It has also...

The use of antidepressants and introduction of new types in different socio-economic groups: A Danish registry-based cross-sectional study

Background: Danish registry-based studies have found socio-economic differences in drug use. The extent to which the use of antidepressants differs between socio-economic groups is unknown. Aim: 1) to examine the association between socio-economic status (SES) and use of antidepressants 2) to evaluate the introduction of new types of antidepressants. Methods: A registry-based cross-sectional study linking information from administrative registries in North Jutland County, Denmark, 1995–99. Main outcome measures: 1) the prevalence proportion for use of antidepressants in different SES groups and by sex, and the estimated prevalence proportion ratio; 2) the proportion using the new drugs in different socio-economic groups through the study period. Results: Women used antidepressants more than twice as often as men with an increasing tendency for both men and women. The use of antidepressants was highest in persons outside the labour market. Among employees, the proportion using new types of antidepressants increased from 1% to 18%. High SES seemed to correlate to higher use of new antidepressants. The new antidepressants were introduced faster among men compared with women. Conclusion: The study showed differences in purchase of antidepressants in different SES groups. Furthermore, it showed faster introduction of new antidepressants among men and employees with high SES.